Mothers Living With HIV and Their Adolescent Children (TALK LA)

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Context: Mothers living with HIV (MLH) and their children face predictable challenges: maintaining physical and mental health, parenting while ill, and addressing HIV-related stressors.

Objective: To evaluate the efficacy of a family-based intervention over time; to contrast the life adjustments of HIV-affected families and their non-HIV-affected neighbors in the current treatment era.

Design: Randomized controlled trial of MLH and a longitudinal comparison of MLH to a neighborhood cohort using random effect regression.

Participants and Intervention: MLH (n = 339) and their school-age children (n = 259) were randomly assigned to receive 1) an intervention of 16 sessions in a cognitive-behavioral, small-group format; or 2) control. MLH and their children were compared to non-HIV-affected families recruited at shopping markets. Participant retention was high: 84% at 6 months, 83% at 12 months, and 78% at 18 months.

Main Outcome Measures: Family functioning and conflict, mental and physical health, sexual behavior, and substance use.

Mothers living with HIV, Cognitive-behavioral intervention delivered in either English- or Spanish-speaking groups of 5 to 8 mothers living with HIV twice weekly for 1.5 to 2 hours each over eight weeks (n = 16 sessions)

Behavioral: Cognitive-behavioral, small-group format sessions

The intervention was delivered in either English- or Spanish-speaking groups of 5 to 8 mothers living with HIV twice weekly for 1.5 to 2 hours each over eight weeks (n = 16 sessions).

No Intervention: Control, mothers living with HIV

Mothers living with HIV, offered intervention at end of study (18 months after recruitment)

No Intervention: Control, non-HIV-infected mothers

Neighborhood control mothers not infected with HIV, did not receive any intervention

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Ages Eligible for Study:

18 Years and older (Adult, Senior)

Sexes Eligible for Study:

Female

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria for Intervention/Control, mother living with HIV:

Mother or primary female caregiver

Enrolled in HIV-related clinical cares

At least one child between the age of 6 and 20 years

Inclusion Criteria for neighborhood control, non-HIV-affected mother:

Mother or primary female caregiver

not HIV-positive

At least one child between the age of 6 and 20 years

Exclusion Criteria (Intervention/Control/Neighborhood):

Mother less than 18 years old

Unable or willing to give informed consent

Psychosis or neurological damage as judged by the investigator in consultation with clinical supervisor